Individual provider Active NPI

Brian A. Kuettel, HAD

  • Hearing Instrument Specialist
  • Mesa, AZ
National Provider Identifier
1487906681
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HAD5865 Issued in AZ
Practice address
319 S Power Rd
Mesa, AZ 85206-5295
Phone
(480) 325-9097
Fax
(480) 924-7930
NPI assigned
Oct 11, 2012
Last updated
Oct 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HAD5865 AZ Primary

Addresses

Primary practice location

319 S Power Rd
Mesa, AZ 85206-5295

Mailing address

8800 SE Sunnyside Rd
Suite 300-N
Clackamas, OR 97015-5738
Phone (503) 659-5115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
HAD5865AZMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Northland Hearing Centers, Inc. Hearing Instrument Specialist Past Accepting new patients
McCrae Management & Investments, LTD. Hearing Instrument Specialist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1487906681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8800 SE SUNNYSIDE RD",
            "address_2": "SUITE 300-N",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970155738",
            "telephone_number": "503-659-5115",
            "fax_number": "503-659-5968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S POWER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852065295",
            "telephone_number": "480-325-9097",
            "fax_number": "480-924-7930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUETTEL",
        "first_name": "BRIAN",
        "middle_name": "A.",
        "credential": "HAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "AZ",
            "license": "HAD5865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.